Fibrinogen/C reactive protein ratio as a parameter for diagnosis of disseminated intravascular coagulation in patients with sepsis / 中华急诊医学杂志

ABSTRACT

Objective To determine if the fibrinogen/C reactive protein (CRP) ratio could be used in sepsis patients as a predictor for disseminated intravascular coagulation.Methods A total of 61 patients with sepsis admitted to emergency intensive care unit (EICU) were enrolled.C reactive protein (CRP) and variables of coagulation such as Platelet (PLT),prothrombin time (PT),activated partial thrombopastin time (APTT),fibrinogen and D-dimer were analyzed during 24 hours after admission to EICU.APACHE Ⅱ score,ISTH score and JAAM score were evaluated.According to DIC score (JAAM score and ISTH score),the patients were divided into two groupsovert DIC and no overt DIC.Data were expressed in mean ±standard deviation and were statistically analyzed by SPSS 17.0.The differences of CRP,PLT,PT,APTT,fibrinogen and D-dimer of patients in each group were analyzed by independent samples t test.The receiver-operating characteristics (ROC) analysis was performed to predict the diagnostic power of the variables fibrinogen,CRP,and fibrinogen/C reactive protein (CRP) ratio.In addition,the odds ratios (OR) were estimated by chi-square test and the 95％ confidence intervals were calculated.Results In overt DIC group fibrinogen/C reactive protein (CRP) ratio was significantly lower.The receiver-operating characteristic analysis showed for the fibrinogen/C reactive protein (CRP) ratio (area under the curveISTH criteria 0.691 and JAAM criteria 0.814) significantly better discriminative power than for fibrinogen (area under the curveISTH criteria 0.608 and JAAM criteria 0.429) and CRP (area under the curveISTH criteria 0.561 and JAAM criteria 0.788).The odds ratio for fibrinogen/C reactive protein (CRP) ratio (＜ 45) was 11.14 and CRP (＞ 70 mg/L) was 8.05.Conclusions We suggest that the fibrinogen/C reactive protein (CRP)ratio could be a diagnostic factor for the occurrence of disseminated intravascular coagulation in sepsis patients.